The NHS is forking out around £250,000 a day to private ambulance firms to help it cope with a crippling shortage of paramedics.
England’s 10 major ambulance trusts paid £92.5million on private transport last year – up from £90.9million the year before.
A shocking investigation shows in some parts of the country, almost a fifth of all 999 calls are attended to by a private ambulance or taxi.
Some trusts warned the chronic shortage of NHS staff and ongoing problems with recruitment is to blame on private ambulances and taxis.
There are feared to be around 100,000 vacancies in the health service, including thousands of vacant posts for paramedics.
It comes after a damning report earlier this year by the Care Quality Commission (CQC) warned that patients were being put at risk by private ambulances.
Data showed the East of England Ambulance Service NHS Trust, which covers six counties including Essex and Norfolk, had the biggest yearly gain in spending
It found that some firms were failing to obtain references or carry out criminal records checks while a lack of staff training was leading to serious patient harm.
The Press Association investigation obtained data from all 10 of the major ambulance trusts in England through Freedom of Information requests.
The probe asked how much they each spent on private ambulances and taxis, and whether these were used for 999 calls or non-emergency patient transfers.
Private ambulances include those hired from local firms as well as charities, including the Red Cross and St John’s Ambulance.
Data showed the East of England Ambulance Service NHS Trust, which covers six counties including Essex and Norfolk, had the biggest yearly gain in spending.
It went from forking out £4,791,155 on private ambulances for 999 and non-urgent work in 2017/18 to £9,535,027 in 2018/19.
Some 26,428 emergency calls (5.21 per cent) involved a private ambulance in the region – up from 12,947 the year before, the figures revealed.
The East of England Ambulance Service NHS Trust said it had hired hundreds of new staff but used private ambulances for overtime and spikes in demand, such as in winter.
England’s 10 major ambulance trusts paid £92.5million on private transport last year – up from £90.9million the year before
It added: ‘We continue to use private ambulance services so that we can respond to patients as quickly as possible and give them the best possible service.’
South Central Ambulance Service increased its spend on private ambulances for 999 calls, forking out £15,382,218, up from £12,994,544 the year before.
The number of 999 incidents attended to by private ambulances also rose, to 989,811 (17.69 per cent) in 2018/19 from 917,521 (16.19 per cent) the year before.
South Central said: ‘Private providers ensure that despite vacancies in our frontline workforce we can ensure that the expected level of demand for our 999 service can be met.’
East Midlands Ambulance Service also spent more on private ambulances for 999 and non-urgent patient work, from £3,974,000 in 2017/18 to £6,969,000 last year.
In 2017/18, 4.6 per cent of all its 999 work (29,681 incidents) was carried out by private ambulances. But this rose in 2018/19 to 7.2 per cent (48,686 incidents).
A statement from East Midlands said private ambulances helped it ‘bridge the vacancy gap while we recruit and train people to work on our frontline’.
‘Ambulance crews are highly-skilled clinicians and it is not possible to recruit and train staff within a short period of time,’ it added.
‘Since May 2018, EMAS has recruited over 200 additional frontline colleagues, with the majority completing their training and starting to join our ambulance crews out on the road.’
West Midlands Ambulance Service, which recently lost its contract to supply non-emergency patient transport, spent nothing on private ambulances in 2018/19.
However, it doubled its spend on taxis to transport patients for non-urgent work, spending £4,082,556 in 2018/19, up from £2,028,745 the year before.
While some individual ambulance services increased their spend on private ambulances and taxis, others spent less than the year before.
Among those spending less were the North West Ambulance Service and South Western Ambulance Service NHS Foundation Trust.
Shadow health secretary Jonathan Ashworth said: ‘Labour have longed warned against the risky, wasteful practice of privatising patient transport services.
‘Matt Hancock promised no privatisation on his watch and yet just in the last few weeks another patient transport service in Worcestershire was privatised.
‘Patients are utterly fed up of profiteering companies like this taking our NHS for a ride. Labour will end the Tory privatisation racket and put patients, not profit, first.’
Unison national ambulance officer Colm Porter said: ‘Spiralling costs for private ambulance hire are siphoning tens of millions from squeezed NHS budgets that would be better spent elsewhere.
‘Research suggests private firms are cutting corners and failing to provide the level of care needed for patients.
‘The NHS sorely needs investment to address staff shortages and stem the flow of departures from the ambulance service, rather than papering over the cracks.’
The CQC report in March warned patients were being put at risk from private ambulances. It said: ‘Many providers had no, or very limited, training for their staff.’
The regulator found ‘ongoing issues with poor recruitment, training and safeguarding processes, with evidence of incidents of serious harm to people from staff that had not been properly recruited and vetted’.
In one example, inspectors heard how a driver believed he could drive the wrong way down a one-way street if he had a blue light on.
In another, ‘an extremely confused dialysis patient was found wandering in the street’ after crews failed to make sure he got into his home safely.
A statement from the Independent Ambulance Association (IAA) said the support provided by independent ambulance providers to NHS ambulance trusts is ‘vital’.
It said private providers must be registered with the CQC and are subject to additional and rigorous checks by NHS trusts.
‘Our view is monies spent on independent ambulance providers by NHS ambulance trusts are an investment to ensure the highest standard of care is provided,’ it added.
The IAA said it was consulting on a quality framework for its members ‘that will provide greater assurance for those commissioning services in areas not currently covered by the CQC’.
A Department of Health and Social Care spokesman said: ‘We are committed to a world-class NHS free at the point of use and the proportion of spend on the independent sector in the last financial year is at the same level as 2014/15.
‘With record numbers of paramedics in the ambulance service, we are supporting them to deliver the response patients need in an emergency, including investing more than £36million for trusts to buy 256 new vehicles and introducing improved performance standards.’